Home or away? Differences between home- and clinic-based dental examinations for older people

The provision of mobile dental services to dependent elderly people in Switzerland

OBJECTIVE

This work aimed at describing mobile dental services provided by both the private sector and the universities in Switzerland to dependent elderly people. It also aimed at presenting the views of both sectors on the current status of these services.

BACKGROUND

As people age and become more care-dependent, their oral health requirements increase, as access to dental care decreases.

METHOD

A survey was sent to practitioners who potentially provided a mobile dental service (n = 253). Five interviews were conducted with six individuals who have a leading role in Geriatric dentistry in the four universities in Switzerland that provide dental training.

RESULTS

The private sector provides a mobile dental service to the elderly mainly through the use of portable equipment, while university services are provided by different models. The interviewees discussed the reasons as to why these services were set up. They discussed the challenges associated with treating dependent elderly patients, which often makes work in this field hard and unattractive. Both sectors see the need for better collaboration with other professionals.

CONCLUSION

The private sector in Switzerland provides a mobile dental service to elderly people mostly through the use of portable equipment, while university services are provided in a variable configuration of models. Better collaboration is required to improve dental care and service delivery to dependent elders. There is a potential for improvement of these services, in order to meet the demand of an ageing population, catering for both the institutionalised elders and those living at home.

Global and regional estimates of the prevalence of root caries - Systematic review and meta-analysis

Aim

To evaluate the pooled prevalence of root caries through a systematic review and meta-analysis.

Methods

A keyword search was done in Scopus, Pubmed and CINAHL databases using all the synonyms of root caries in the published literature (till January 1st, 2018). The search was supplemented with standard Boolean operators and other keywords like prevalence, epidemiology in the title, abstract and MeSH terms. Data was extracted and exported to Covidence software for screening and removal of duplicates.

Results

The search revealed a total of 492 documents from Scopus (n = 95), Pubmed (n = 220) and CINAHL (n = 177). Random effects model was used as there was a high degree of heterogeneity was seen among the studies published (I² = 99.62%). A total of 74 publications were included in the analysis of the pooled prevalence of root caries which yielded a prevalence of 41.5 (36.9–46.1).

Conclusion

Root caries is a significant problem, and four out of ten adults might be affected.

Root caries: a periodontal perspective

BACKGROUND AND OBJECTIVE

A prevailing dental problem in the periodontal patient is root caries. Specifically, periodontal involvement often results in root surfaces becoming exposed and at risk for this condition. Periodontal therapy often leads to increased gingival recession as well, and the associated increased root caries risk may compromise the long-term success and survival of periodontally treated teeth.This narrative review will address the topic of root caries in the periodontal patient, focusing on unmet research needs.

MATERIAL AND METHODS

The Medline database was searched to identify items dealing with root caries, in terms of clinical features, diagnosis, pathogenic mechanisms and histopathology, as well as epidemiology, focusing then on the relationship between root caries and periodontal disorders.

RESULTS

Although there is extensive literature on root caries, consensus is lacking regarding certain aspects, such as diagnostic criteria, prevalence within populations and indisputable risk factors. Advancing age could be an aggravating factor in susceptibility to root caries for the periodontal patient; however, definitive evidence in this regard is still missing. Similarly, full awareness of the increased risk of root caries in patients with periodontal disease or long-term periodontal treatment appears to be still lacking.

CONCLUSION

Research regarding root caries in age-specific (elderly) periodontal patients is needed. Improved oral hygiene practices, locally applied preventive measures, good dietary habits and regular dental check-ups are crucial approaches to prevent both periodontal disease progression and root caries. Periodontal patients with root exposure should follow a strict root caries prevention protocol, as an integral component of their periodontal maintenance therapy.